Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Possible hemodynamic pathways of intraurethral prostaglandin-E1 (MUSE™)

Abstract

Intraurethral application of prostaglandin-E1 (MUSE™) is a well-tolerated pharmacotherapy for erectile dysfunction. However, the physiological mechanisms of drug transfer into the cavernous bodies are not completely clear. Using spongiosography in 35 patients, our study tried to elucidate existing shunt mechanisms. The X-rays show venous drainage through the deep dorsal vein up to the plexus Santorini. The circumflex veins are also contrasted and the cavernous bodies show opacification in their distal portion only. Structures shunting directly between the corpus spongiosum and the cavernous bodies were not demonstrable. Retrograde filling of the cavernous bodies through the deep dorsal vein and its circumflex braches seems to be the most relevant way of drug transfer after intraurethral application of prostaglandin-E1. Diffusion into the cavernous bodies or a systemic mechanism of action does not seem probable.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Porst H . The rationale for prostaglandin E1 in erectile failure: a survey of worldwide experience. J Urol 1996; 155: 802–815.

    Article  CAS  Google Scholar 

  2. Porst H . Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil—a comparative study in 103 patients with erectile dysfunction. Int J Impot Res 1997; 9: 187–192.

    Article  CAS  Google Scholar 

  3. Hauck EW et al. Prostaglandin E1 long-term self-injection programme for treatment of erectile dysfunction—a follow-up of at least 5 years. Andrologia 1999; 31(Suppl 1): S99–S103.

    Google Scholar 

  4. Linet OI, Ogrinc FG . Penile fibrosis during 18 months of intracavemosal therapy with alprostadil (Caverject™). Int J Impot Res 1996; 8: D85.

    Google Scholar 

  5. Porst H et al. Final results of a prospective multicenter-study with self-injection therapy with PGE1 after 4 years of follow-up. Int J Impot Res 1996; 8: D118.

    Google Scholar 

  6. Padma-Nathan H et al. Hemodynamic effects of intraurethral alprostadil: the medicated urethral system for erection (MUSE™). J Urol 1994; 151: 345, A469.

    Google Scholar 

  7. Shokeir AA, Alserafi MA, Mutabagani H . Intracavernosal versus intraurethral alprostadil: a prospective randomized study. BJU Int 1999; 83: 812–815.

    Article  CAS  Google Scholar 

  8. Porst H . Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil—a comparative study in 103 patients with erectile dysfunction. Reply. Int J Impot Res 1998; 10: 62.

    Article  Google Scholar 

  9. Engel JD, McVary KT . Transurethral alprostadil as therapy for patients who withdrew from or failed prior intracavernous injection therapy. Urology 1998; 51: 687–692.

    Article  CAS  Google Scholar 

  10. Lewis RW . Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil—a comparative study in 103 patients with erectile dysfunction. Letter to the Editor. Int J Impot Res 1998; 10: 61.

    Article  CAS  Google Scholar 

  11. Engelhardt PF, Plas E, Hübner WA, Pflüger H . Comparison of intraurethral liposomal and intracavernosal prostaglandin-E1 in the management of erectile dysfunction. Br J Urol 1998; 81: 441–444.

    Article  CAS  Google Scholar 

  12. Hatzichristou DG . Current treatment and future perspectives for erectile dysfunction. Int J Impot Res 1998; 10(Suppl 1): S3–S13.

    PubMed  Google Scholar 

  13. Meinhardt W, Kropman RF, Vermeij P . Comparative tolerability and efficacy of treatments for impotence. Drug Saf 1999; 20: 133–146.

    Article  CAS  Google Scholar 

  14. Williams G et al. The effect of transurethral alprostadil on the quality of life of men with erectile dysfunction, and their partners. Br J Urol 1998; 82: 847–854.

    Article  Google Scholar 

  15. Costabile RA et al. Efficacy and safety of transurethral alprostadil in patients with erectile dysfunction following radical prostatectomy. J Urol 1998; 160: 1325–1328.

    Article  CAS  Google Scholar 

  16. O'Leary MP et al. Transurethral alprostadil improves quality of life for patients and partners. Int J Impot Res 1996; 8: A68.

    Google Scholar 

  17. Wilke RJ et al. Quality of life effects of Alprostadil therapy for erectile dysfunction in the US and Europe. Int J Impot Res 1996; 8: 113, A58.

    Google Scholar 

  18. Vardi Y, Saenz de Tejada I . Transfer of vasodilator drugs from the glans and corpus spongiosum to the corpora cavernosa. Int J Impot Res 1996; 8: 130, D33.

    Google Scholar 

  19. Vardi Y, Saenz de Tejada I . Functional and radiologic evidence of vascular communication between the spongiosal and cavernosal compartments of the penis. Urology 1997; 49: 749–752.

    Article  CAS  Google Scholar 

  20. Tam PY et al. Hemodynamic effects of transurethral alprostadil measured by color duplex ultrasonography in men with erectile dysfunction. J Urol 1998; 160: 1321–1324.

    Article  CAS  Google Scholar 

  21. Wagner G, Bro-Rasmussen F, Willis EA, Nielsen MH . New theory on the mechanism of erection involving hitherto undescribed vessels. Lancet 1982; 2: 416–418.

    Article  Google Scholar 

  22. Gesundheit N et al. The pharmacokinetics of transurethral alprostadil (Prostaglandin E1) in men with erectile dysfunction. J Urol 1997; 157(Suppl): 259, A1013.

    Google Scholar 

  23. Chiang HS, Kao YH, Sheu MT . Papaverine and prostaglandin E1 gel applications for impotence. Ann Acad Med Singapore 1995; 24: 767–769.

    CAS  PubMed  Google Scholar 

  24. Padma-Nathan H et al. Improved erectile response to transurethral alprostadil by use of a novel, adjustable penile band. J Urol 1997; 157(Suppl): 181, A704.

    Google Scholar 

  25. Lue TF, Tanagho EA . Functional anatomy and mechanism of penile erection. In: Tanagho EA, Lue TF, McClure RD (eds). Contemporary Management of Impotence and Infertility. Williams & Williams: Baltimore, 1988, pp 39–50.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E W Hauck.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bschleipfer, T., Cimniak, HU., Beckert, R. et al. Possible hemodynamic pathways of intraurethral prostaglandin-E1 (MUSE™). Int J Impot Res 16, 365–368 (2004). https://doi.org/10.1038/sj.ijir.3901163

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901163

Keywords

Search

Quick links